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Solution To Azoospermia with TESA And IVF-ICSI Technique at Nova IVF, Vijayawada
Mr R aged 30 years and Mrs B aged 26 years were living a marital life for five years with joy and happiness. The only sad thing was that they were not taking off on the parenthood journey as they were not conceiving naturally. They visited multiple doctors. Male partner was diagnosed to have Oligoasthenoteratozoospermia initially (2017) which later progressed to persistent Azoospermia. Couple were advised Donor sperm usage for conception. But the couple decided to visit a fertility specialist to find out the cause.
Dr. Sreelakshmi Atluri, Fertility Specialist at Nova IVF, Vijayawada helped them diagnose their issue and suggested a treatment plan. They decided to continue the treatment with us. The treatment was a combination of 2 techniques. And finally, they were able to conceive through IVF-ICSI and deliver a child.
History of the couple
Mrs. B reported she had a regular menstrual history. Ultrasound scans and routine blood investigations were done which came out to be normal.
Past History of the Male Partner
Mr. R's history had a condition called OligoAsthenoteratozoospermia in 2017 and latter persistent Azoospermia from 2019.
OligoAsthenoteratozoospermia
It is the most common kind of male infertility. OligoAsthenoteratozoospermia is a condition in which the semen sample has Oligozoospermia, which is a low sperm count, Asthenozoospermia, which is poor motility, and teratozoospermia, which is abnormal morphology of sperm.
Azoospermia
It is a condition of complete absence of sperm from fluid ejaculated during orgasm ie:- semen. Azoospermia is caused because of an obstruction in the reproductive tract or inadequate sperm production.
Semen Analysis of the Male Partner
Mr. R reported that he had sudden onset of pain in his left testes in the year 2014. Torsion testes (a twisting of the male organ that makes hormones and sperm) for which he was treated medically. Later there was a gradual decline in the size of Lt testes.
In addition, Mr. R also underwent surgery for a right inguinal hernia in the year 2014. He was also diagnosed with Mumps in the year 2019.
In other fertility clinics, the couple was advised of Donor sperm IUI before they visited NOVA IVF in November 2020.
Diagnosis At Nova IVF
The male partner was evaluated with Azoospermia (It is a condition of complete absence of sperm from fluid ejaculated during orgasm, i.e., semen). Azoospermia is caused because of an obstruction in the reproductive tract or inadequate sperm production from testes either because of reduced hormone production from brain or defective testicular sperm production
On scrotal scan and Doppler, it was found that the Left testes is absent, the right testes is of subnormal size and have Grade 2 varicocele (A varicocele is an abnormal enlargement of the pampiniform venous plexus in the male scrotum) .
Hormonal evaluation of male partner revealed: FSH - 23, LH- 11 and the level of testosterone is 13 pg/ml pointing towards testicular reason for Azoospermia
Counseling and Management
After the diagnosis, Dr. Sreelakshmi prescribed Mr R medication for 3 months before going to IVF-ICSI. Controlled ovarian stimulation was done for the female partner in February 2021.
On the day of female partner egg pick up, TESA (Testicular Sperm Aspiration) done to male partner from Right testes, Sperms were retrieved and IVF-ICSI of eggs done with husband’s testicular sperms.
TESA
TESA stands for Testicular Sperm Aspiration. A needle is inserted in the testicle and tissue/sperm are aspirated. Sperms retrieved can be used for ICSI.
ICSI
Intracytoplasmic sperm injection is an in vitro fertilization (IVF) procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. This technique is used to prepare the gametes for the obtention of embryos that may be transferred to a maternal uterus. With this method, the acrosome reaction is skipped.
Embryo Transfer
It is the procedure performed to place the embryo in the uterus. It is an easy yet crucial procedure in the IVF technique. It is the final stage of the IVF life cycle following gamete fertilization and embryo formation in the laboratory.
The lady conceived after the 1st embryo transfer which was successfully performed by Dr. Sreelakshmi at Nova IVF, Vijayawada. The proper care and regular checkups were done by Dr. Sreelakshmi at Nova IVF at regular intervals. They have a baby of 18months now and the couple are extremely happy to have a baby of their own gametes. So, if you too have any issues conceiving a baby, we at Nova IVF can help you conceive and live happily with your child.
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